Revised hours and workloads for medical residents needed ...(aduate training should be permitted to t...),Health

Date:12/2/2008

aduate training should be permitted to treat during a shift, the report adds. Only the Internal Medicine Residency Review Committee has set such guidelines. They are necessary because heavy workloads and the compression of work into fewer hours contribute to safety risks for both patients and residents.

Health care facilities should schedule an overlap of residents' schedules during shift changes to enable optimal transitions of patients' care from one team to another, the report adds. Patient handovers have been identified as among the likeliest times for errors to occur, often because of poor communication among care providers.

A major concern stemming from the 2003 duty hour regulations is the effect they have had on the availability of staff to handle teaching hospitals' caseloads and provide quality care while also providing residents with adequate supervision and training, as workloads have shifted among staffers or been compressed into shorter working hours. The committee acknowledged its recommendations will increase the number of residents, midlevel providers, and trained physicians needed to provide 24-hour coverage in training hospitals and clinics.

To implement the report's recommendations, some of the work currently performed by residents would have to be done by others. The committee estimated that the cost for additional personnel to handle reduced resident work could be roughly $1.7 billion annually. This is less than half of 1 percent of what Medicare spends on care for older Americans annually. As another IOM report on medication errors noted, the extra medical costs of treating drug-related injuries occurring in hospitals conservatively amount to $3.5 billion a year.

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Contact: Christine Stencel news@nas.edu 202-334-2138 National Academy of Sciences Source:Eurekalert

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